Caring through the advancing years

Living with the elderly requires an understanding of the specific problems that come with age. “Caregivers have to be sensitized to recognize these conditions and to provide adequate support,” says Radha Murthy, founder, Nightingales Home Health Services, a geriatric care service in Bangalore. It is also important to understand that older people are not unwell all the time. “It is just that the expression of even a mild affliction tends to be more acute in an older person, so there should be a different perspective when dealing with them,” adds Kushagra Katariya, CEO, Artemis Health Institute, Gurgaon.

Older people are more prone to side effects from regular medication: For instance, sodium levels in their body can dip suddenly and to manage this while simultaneously continuing with regular medication for blood pressure and hypertension is a specialized task that requires focus on geriatric care.

Their diagnostic tests have to be customized: As age-related problems are different from the afflictions of younger or even middle-aged adults, there should be customized tests that take into account age group and lifestyle as well as family history. “For instance, screening for dementia among elders can help pick up conditions such as deficiency of vitamin B12, which is a causative factor for Alzheimers disease,” says Murthy.

They tend to typically have more than one ailment: Multiple chronic problems such as diabetes, combined with BP or cardiac complications, are an offshoot of ageing. Medical care for the elderly therefore needs to be specialized for holistic treatment.

Psychological/emotional care must complement physical treatments: “Most often, all that an elderly person needs is reassurance,” says Katariya. This approach to geriatric medicine must factor in issues such as failing eyesight and hearing, low self-esteem and in some cases, mild depression—all of which need to be treated in consonance with actual physical ailments.

According to doctors, India needs more geriatric specialists. George Oommen, head, health services, HelpAge India, says: “Only Madras Medical College, Chennai, offers an MD in geriatrics.” Most geriatricians in India, whether in hospitals or private practice, are either trained overseas or become specialists through experience and on-the-job training, he notes. “Institutions such as AIIMS, New Delhi, and Christian Medical College, Vellore, have advanced geriatric services, but we need more,” he adds.

Tips for the later years from Oommen:

• Undergo periodic health checks after 40. Seniors are more prone to some diseases, especially chronic, non-communicable ones. Stressful events also affect them severely. A trusted family doctor can allay fears, regulate medication and prescribe tests.

• Stay involved in cultural, spiritual, financial and civic affairs.

• Participate in family life, including your children’s problems.

• Secure yourself financially.

• Watch out for abuse of elders. World Health Organization (WHO) estimates 4-6% of the elderly worldwide suffer abuse.

“Most older persons are treated at secondary or tertiary care hospitals by physicians who are not specialized in geriatrics,” laments Oommen. However, the government is planning to start MD courses in geriatrics at 25 medical colleges during its current five-year plan, besides two Institutes of Aging in New Delhi and Chennai. District and sub-district level health interventions to improve geriatric healthcare in 100 districts is also part of the plan.